【摘要】：目的:探討肌間溝聯(lián)合腋路臂叢神經(jīng)阻滯麻醉對術(shù)中止血帶反應(yīng)的影響。方法:選取功能神經(jīng)外科擇期行上肢手術(shù)治療的200例患者,按照麻醉方式不同分為觀察組(肌間溝聯(lián)合腋路臂叢神經(jīng)阻滯麻醉)和對照組(單純肌間溝或單純腋路阻滯麻醉),觀察兩組感覺神經(jīng)和運(yùn)動(dòng)神經(jīng)阻滯的起效時(shí)間和持續(xù)時(shí)間、不良反應(yīng)發(fā)生率、止血帶反應(yīng)時(shí)心率、平均動(dòng)脈壓水平。結(jié)果:觀察組感覺神經(jīng)和運(yùn)動(dòng)神經(jīng)的阻滯持續(xù)時(shí)間均長于對照組,感覺神經(jīng)阻滯起效較對照組快,P0.05;觀察組不良反應(yīng)發(fā)生率(9.52%)與對照組(14.74%)間差異不顯著,P0.05;止血帶反應(yīng)時(shí),觀察組心率、平均動(dòng)脈壓分別為(90.78±11.30)次/min、(87.56±6.21)mmHg(1mmHg=0.133kPa),較對照組的(101.52±12.43)次/min、(90.42±6.52)mmHg低,P0.05。結(jié)論:與單純肌間溝或單純腋路阻滯麻醉相比,肌間溝聯(lián)合腋路臂叢神經(jīng)阻滯麻醉有以下顯著優(yōu)勢:(1)麻醉起效快,麻醉持續(xù)時(shí)間長;(2)不增加止血帶反應(yīng)等不良反應(yīng);(3)發(fā)生止血帶反應(yīng)時(shí)患者血流動(dòng)力學(xué)指標(biāo)波動(dòng)小,安全性高。
[Abstract]:Objective: to investigate the effect of intermuscular sulcus combined with axillary brachial plexus block on the stop of blood band reaction. Methods: 200 patients who were selected for upper limb operation in functional neurosurgery were divided into observation group (intermuscular sulcus combined with axillary brachial plexus block anesthesia) and control group (simple intermuscular sulcus or simple axillary block anesthesia) according to different anaesthesia methods. The onset time and duration of sensory and motor nerve block, incidence of adverse reactions, heart rate and mean arterial pressure during tourniquet reaction were observed. Results: the duration of sensory nerve block and motor nerve block in the observation group was longer than that in the control group, and the onset of sensory nerve block was faster than that in the control group (P0.05). The incidence of adverse reactions in the observation group (9.52%) was not significantly different from that in the control group (14.74%) (P 0.05). During tourniquet reaction, the heart rate and mean arterial pressure were (90.78 鹵11.30) times / min, (87.56 鹵6.21) mmHg (1mmHg=0.133kPa) in observation group, lower than (101.52 鹵12.43) times / min, (90.42 鹵6.52) mmHg in control group (P 0.05). Conclusion: compared with simple intermuscular sulcus or axillary block anesthesia, the intermuscular sulcus combined with axillary plexus block anesthesia has the following significant advantages: (1) the anesthetic effect is fast and the anesthesia duration is long; (2) the side effects such as tourniquet reaction were not increased, (3) the hemodynamic parameters of patients with tourniquet reaction fluctuated little and the safety was high.
【作者單位】： 湖北省公安縣中醫(yī)院麻醉科;
【分類號(hào)】：R614.4

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